PEDIATRICS Vol. 82 No. 6 December 1988, pp. 888-895
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Cocaine Use During Pregnancy: Prevalence and Correlates

Deborah A. Frank MD1, Barry S. Zuckerman MD1, Hortensia Amaro PhD1, Kwabena Aboagye MD1, Howard Bauchner MD1, Howard Cabral MPH1, Lise Fried MS1, Ralph Hingson ScD1, Herbert Kayne PhD1, Suzette M. Levenson MPH1, Steven Parker MD1, Hilary Reece BS1, and Robert Vinci MD1

1 From the Division of Developmental and Behavioral Pediatrics, the Department of Pediatrics, and the Department of Obstetrics and Gynecology, Boston City Hospital, the Boston University School of Medicine, and the Boston University School of Public Health, with The State Laboratory Institute and Theobald Smith Research Institute, Boston

Cocaine use during pregnancy was assessed by interviews and urine assays obtained prenatally and immediately postpartum from 679 urban women enrolled in prenatal care. Of these, 17% were found to have used cocaine at least once during pregnancy. Eight percent had urine assays positive for cocaine metabolites using the enzyme-mediated immunoassay technique with a cutoff of 300 ng/mL of benzoylecgonine. Of the cocaine users, 24% denied use at the time of the interview and were identified solely by urine assay. Cocaine users were significantly (P < .01) less likely than nonusers to be married, Hispanic, or black born outside of the United States and were less well nourished. Users reported significantly (P < .01) more sexually transmitted diseases, prior low birth weight infants, spontaneous and elective abortions, and greater use of alcohol, cigarettes, marijuana, opiates, and other illicit drugs during pregnancy. Because cocaine use is correlated with many potential risk factors, large sample sizes and multivariate statistical techniques are needed to determine whether cocaine use during pregnancy poses an independent risk for adverse neonatal outcomes.

Key Words: cocaine • pregnancy • marijuana • prenatal care

Submitted on October 7, 1987
Accepted on December 31, 1987


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